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VER MAS
REPÚBLICA DE COLOMBIA
Declaración de Importación
Privada
500
1. Año 2024
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
032024001286124-4
5 . Número de Identificación Tributaria (NIT)
830028931 13 . Dirección
CR 7 113 43 OF 607
6 . DV. 5
11 . Apellidos y nombres o Razón Social
SAMSUNG ELECTRONICS COLOMBIA S.A.
15 . Teléfono 12 . Cód. Admón. 16 . Cód. Dpto 17 . Cód. Ciudad Municipio
4870707 03 11 001
24 . Número de Identificación Tributaria (NIT)
860536003
29 . Número documento de identificación
102294385
25 . DV. 3
26 . Razón social del declarante autorizado 27 . Tipo usuario 28 . Cód. usuario
AGENCIA DE ADUANAS ABC REPECEV S.A.S. NIVEL 1 26 99 30 . Apellidos y nombres
CARLOS ANDRES ROJAS MATAJUDIOS
31 . Clase 32 . Tipo declaración 33 . Cod. 34 .No.Formulario Anterior 35 . Año – Mes – Día 36 . Cod. Admón. 37 . Declaración de Exportación 38 . Año – Mes – Día 39 . Cod. Admón. Importador Inicial 1 XXXXXXXXXXXXXX XXXX – XX – XX XX No. XXXXXXXXXXXXXXX XXXX – XX – XX XX
02
40 . Cod. lugar ingreso 41 . Cod. Depósito 42 . Manifiesto de carga 43 . Año – Mes – Día 44 . Documento de transporte 45 . Año – Mes – Día de las mercancías 99900 No. 116575014777943 2024 – 09 – 15 No. SHAN0342078 2024 – 09 – 06
BOG
46 . Nombre exportador o proveedor en el exterior 47 . Ciudad 48 . Cod.País Exportador SAMSUNG ELECTRONICS CO., LTD GYEONGGI-DO 190
49 . Dirección exportador o proveedor en el exterior 50 . E-mail
129, SAMSUNG-RO, YEONGTONG-GU SUWON 16677 010-8705-6749
51 . No. de factura 52 . Año – Mes – Día 53 . Cod. país 9102864625 2024 – 09 – 06 procedencia 855
54 . Cod. Modo Transporte
4
55 . Código de Bandera
169
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. TAMPA CARGO S.A.S.
4.236.63
S
59 . Subpartida arancelaria 60 . Cod. 8517130000 Complementario
XX
61 . Cod. Suplementario
XX
62 . Cod. Modalidad C134
63 . No. cuotas o meses
XX
64 . Valor cuota USD XXXX
65 . Periodicidad del pago de la cuota
XX
66 . Cod. país 67 . Cod. Acuerdo de origen XXX
855
68 . Forma de pago 69 . Tipo de 70 . Cod. país de la importación importación compra
01 01 190
71 . Peso bruto kgs. dcms.
72 . Peso neto kgs.
dcms. 73 . Código 120.00 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
154.00
500.00
78 .Valor FOB 79 . Valor fletes USD USD
48.672.01
1.104.18
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
2.41
0
Arancel
0
0
0.00
92 93 94 0.00 210.893.510
95
96
I.V.A.
9798 99 100 101
0.00 210.893.510 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.106.59
0.00
Salvaguardia
102 103 104 105 106
0.00 0 0 0 0.00
Derechos 107 Compensatorios
108
109
110
111
0.00
0
0
0
0.00
84 . Valor aduana 85 . Código registro 86 . Número
USD
o licencia
49.778.60
X XXXXXXXXXX
Derechos 112 Antidumping
113
114
115
116
0.00
0
0
0
0.00
Sancion
117 118 119 120 0000
87 . Cod. oficina
99
88 . Año 89 . Programa No 90 . Cód Interno del XXXX XXXXXXXXXX Producto
0
Rescate
121 122 123 124 0000
Total
125 126 0
0.00
91 . Descripción de las mercancías(No inicie la descripción de las mercancías a importar con lo señalado en el arancel de aduanas en la subpartida arancelaria – Incluya marcas, seriales y otros) (Si el campo es insuficiente, continúe al respaldo de este formulario)
NAC: 530689-DECL: 1838838-DO: 893121277241- DECL 1 DE 1.- //NOS ACOGEMOS AL ARTICULO 424 DEL ESTATUTO TRIBUTARIO MODIFICADO POR L
A LEY 1819DEL 29/12/2016 ARTÍCULO 175 NUMERAL 6 (EXCLUSIÓN DEL IVA). // NOS ACOGEMOS AL ARTÍCULO 2.8.3.1 ORDINAL 2.8.3.1.4 DE LA
RESOLUCIÓN 5050 DEL 10 DE NOVIEMBRE DE 2016. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOM
OLOGACIÓN) // NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION.SAMSUNG ELECTRONICS COLOMB
IA S.A. OEA COD. OE0001. . PEDIDOS: 3072686355. ID CONTENEDOR: 6077885092. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A155MZKILTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A15 5G DUOS, (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGR(continúa al respaldo)
127 . Valor pagos anteriores: 0
128 . Recibo oficial de pago anterior No.: XXXXXXXXXXXXXXX 129. Fecha: XXXX XX XX
130 . Espacio reservado DIAN – Actuación aduanera Estado de levante: Levante automático
No hay declaración posterior
131 . Espacio reservado uso exclusivo Ministerio de Relaciones Exteriores
132 . No. Aceptación declaración 032024001286124
133. Feha: 202409 16
134 . Levante No. 032024001208467 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 16
Firma declarante
997 . Espacio exclusivo para el sello de la entidad recaudadora
(Fecha efectiva de la transacción)
Coloque el timbre de la máquina registradora al dorso de este formulario
980 . Pago Total $
0
996 . Espacio para autoadhesivo de la entidad recaudadora (Número del adhesivo)
SYGA
Autoadhesivo 92032406900511
Fecha presentación 2024-09-16 18:13:38 Valor pagado $0.00
Fecha de Impresión: 2024-09-16 18:13:44
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001286124-4 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
O, MODELO: SM-A155M/DSN, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A155M/DSN,BLACK,LTC( QTY. 500,00 u )(500,00
PCE); IMEIS: 355170561103773/355533001103770. 355170561105794/355533001105791. 355170561106008/355533001106005. 355170561106032/
355533001106039. 355170561106057/355533001106054. 355170561106073/355533001106070. 355170561106149/355533001106146. 3551705611062
22/355533001106229. 355170561106248/355533001106245. 355170561106263/355533001106260. 355170561106370/355533001106377.35517056110
6537/355533001106534. 355170561106727/355533001106724. 355170561106826/355533001106823. 355170561106891/355533001106898. 35517056
1106941/355533001106948. 355170561106958/355533001106955. 355170561106990/355533001106997. 355170561107006/355533001107003. 35517
0561107063/355533001107060. 355170561107089/355533001107086. 355170561107105/355533001107102. 355170561107121/355533001107128. 35
5170561107402/355533001107409. 355170561107436/355533001107433. 355170561107444/35553300110 7441. 355170561107576/355533001107573
. 355170561107733/355533001107730. 355170561107907/355533001107904. 355170561107949/355533001107946. 355170561107998/355533001107
995. 355170561108053/355533001108050. 355170561108459/355533001108456. 355170561109515/355533001109512. 355170561109796/355533001
109793. 355170561109812/355533001109819. 355170561109853/355533001109850. 355170561109861/355533001109868. 355170561109887/355533
001109884. 355170561109895/355533001109892. 355170561109903/355533001109900. 355170561109911/355533001109918. 355170561109937/355
533001109934. 355170561109952/355533001109959. 355170561109960/355533001109967. 355170561109986/355533001109983. 355170561110398/
355533001110395. 355170561110406/355533001110403. 355170561110422/355533001110429. 355170561110430/355533001110437. 3551705611104
55/355533001110452. 355170561110463/355533001110460. 355170561110489/355533001110486. 355170561110505/355533001110502. 3551705611
10521/355533001110528. 355170561110554/355533001110551. 355170561110562/355533001110569. 355170561110570/355533001110577. 3551705
61110927/355533001110924. 355170561112485/355533001112482. 355170561112600/355533001112607. 355170561112634/355533001112631. 3551
70561112675/355533001112672. 355170561112691/355533001112698.355170561112980/355533001112987. 355170561112998/355533001112995. 35
5170561113012/355533001113019. 355170561113020/355533001113027. 355170561113046/355533001113043. 355170561113665/355533001113662.
355170561114051/355533001114058. 355170561114119/355533001114116. 355170561114242/355533001114249. 355170561114259/3555330011142
56. 355170561114465/355533001114462. 355170561114804/355533001114801. 355170561114853/355533001114850. 355170561114960/3555330011
14967. 355170561114986/355533001114983. 355170561115033/355533001115030. 355170561115041/355533001115048.355170561115090/35553300
1115097. 355170561115157/355533001115154. 355170561116015/355533001116012. 355170561116130/355533001116137. 355170561116155/35553
3001116152. 355170561116163/355533001116160. 355170561116338/355533001116335. 355170561116528/355533001116525. 355170561116916/35
5533001116913. 355170561116981/355533001116988. 355170561117823/355533001117820. 355170561117872/355533001117879. 355170561117906
/355533001117903. 355170561117922/355533001117929. 355170561117930/355533001117937. 355170561117997/355533001117994. 355170561118
003/355533001118000. 355170561118011/355533001118018. 355170561118029/355533001118026. 355170561118037/355533001118034. 355170561
118045/355533001118042. 355170561118060/355533001118067. 355170561118078/355533001118075. 355170561118086/355533001118083. 355170
561118094/355533001118091. 355170561118128/355533001118125. 355170561118136/355533001118133. 355170561118144/355533001118141. 355
170561118169/355533001118166. 355170561118177/355533001118174. 355170561118193/355533001118190. 355170561118201/355533001118208.
355170561118219/355533001118216. 355170561118227/355533001118224. 355170561118235/355533001118232. 355170561118243/35553300111824
0. 355170561118250/355533001118257. 355170561118276/355533001118273. 355170561118284/355533001118281. 355170561118300/35553300111
8307. 355170561118938/355533001118935. 355170561118961/355533001118968. 355170561119126/355533001119123. 355170561119225/35553300
1119222. 355170561119258/355533001119255. 355170561119357/355533001119354. 355170561119365/355533001119362. 355170561119381/35553
3001119388. 355170561119837/355533001119834. 355170561119951/355533001119958. 355170561120165/355533001120162. 355170561120868/35
5533001120865. 355170561150295/355533001150292.355170561150311/355533001150318. 355170561150394/355533001150391. 355170561150543/
355533001150540. 355170561150600/355533001150607. 355170561150659/355533001150656. 355170561150840/355533001150847. 3551705611508
65/355533001150862. 355170561151087/355533001151084. 355170561151095/355533001151092. 355170561151103/355533001151100. 3551705611
51111/355533001151118. 355170561151129/355533001151126. 355170561151137/355533001151134. 355170561151194/355533001151191. 3551705
61151269/355533001151266. 355170561151442/355533001151449. 355170561151533/355533001151530.355170561151590/355533001151597. 35517
0561151822/355533001151829. 355170561151830/355533001151837. 355170561151848/355533001151845. 355170561151855/355533001151852. 35
5170561151871/355533001151878. 355170561151897/355533001151894. 355170561151905/355533001151902. 355170561151921/355533001151928.
355170561151939/355533001151936. 355170561151947/355533001151944. 355170561151954/355533001151951. 355170561151962/3555330011519
69. 355170561152002/355533001152009. 355170561152218/355533001152215. 355170561152267/355533001152264. 355170561152275/3555330011
52272. 355170561152341/355533001152348. 355170561152358/355533001152355. 355170561152473/355533001152470. 355170561152655/3555330
01152652. 355170561153133/355533001153130. 355170561153166/355533001153163. 355170561153349/355533001153346. 355170561153489/3555
33001153486. 355170561153521/355533001153528. 355170561153570/355533001153577. 355170561153596/355533001153593. 355170561153604/3
55533001153601. 355170561153638/355533001153635. 355170561153646/355533001153643. 355170561153653/355533001153650. 35517056115366
1/355533001153668. 355170561153687/355533001153684. 355170561153729/355533001153726. 355170561153737/355533001153734. 35517056115
3745/355533001153742. 355170561153786/355533001153783. 355170561153802/355533001153809. 355170561153950/355533001153957. 35517056
1154263/355533001154260. 355170561154404/355533001154401. 355170561154412/355533001154419. 355170561154636/355533001154633. 35517
0561155070/355533001155077. 355170561155161/355533001155168. 355170561155260/355533001155267. 355170561155955/355533001155952. 35
5170561156011/355533001156018. 355170561156052/355533001156059. 355170561156110/355533001156117. 355170561156128/355533001156125.
355170561156227/355533001156224.355170561156250/355533001156257. 355170561156276/355533001156273. 355170561156367/35553300115636
4. 355170561156383/355533001156380. 355170561156441/355533001156448. 355170561156474/355533001156471. 355170561156482/35553300115
6489. 355170561156490/355533001156497. 355170561156524/355533001156521. 355170561156557/355533001156554. 355170561156573/35553300
1156570. 355170561156607/355533001156604. 355170561156615/355533001156612. 355170561156771/355533001156778. 355170561156797/35553
3001156794. 355170561156839/355533001156836. 355170561156862/355533001156869.355170561156896/355533001156893. 355170561157035/355
533001157032. 355170561157050/355533001157057. 355170561157068/355533001157065. 355170561157092/355533001157099. 355170561157118/
355533001157115. 355170561157126/355533001157123. 355170561157134/355533001157131. 355170561157142/355533001157149. 3551705611571
83/355533001157180. 355170561157225/355533001157222. 355170561157258/355533001157255. 355170561157282/355533001157289. 3551705611
57308/355533001157305. 355170561157399/355533001157396. 355170561157696/355533001157693. 355170561157738/355533001157735. 3551705
61157746/355533001157743. 355170561157936/355533001157933. 355170561158306/355533001158303. 355170561158330/355533001158337. 3551
70561158348/355533001158345. 355170561158363/355533001158360. 355170561158447/355533001158444. 355170561158801/355533001158808. 3
55170561158868/355533001158865. 355170561158876/355533001158873. 355170561158918/355533001158915. 355170561158942/355533001158949
. 355170561158967/355533001158964. 355170561159478/355533001159475. 355170561159551/355533001159558. 355170561159577/355533001159
574. 355170561159668/355533001159665. 355170561159825/355533001159822. 355170561159866/355533001159863. 355170561159908/355533001
159905. 355170561159924/355533001159921. 355170561159940/355533001159947. 355170561159965/355533001159962. 355170561160013/355533
001160010. 355170561160021/355533001160028. 355170561160047/355533001160044. 355170561160070/355533001160077. 355170561161219/355
533001161216. 355170561161680/355533001161687. 355170561166572/355533001166579. 355170561166580/355533001166587. 355170561166630/
355533001166637. 355170561166705/355533001166702. 355170561166721/355533001166728. 355170561166739/355533001166736. 3551705611668
04/355533001166801.355170561166911/355533001166918. 355170561167216/355533001167213. 355170561167240/355533001167247. 35517056116
7331/355533001167338. 355170561169154/355533001169151. 355170561169220/355533001169227. 355170561169436/355533001169433. 35517056
1169519/355533001169516. 355170561169550/355533001169557. 355170561169568/355533001169565. 355170561169584/355533001169581. 35517
0561169592/355533001169599. 355170561169600/355533001169607. 355170561169626/355533001169623. 355170561169667/355533001169664. 35
032024001286124-4
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001286124-4 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
5170561169683/355533001169680. 355170561169691/355533001169698.355170561169725/355533001169722. 355170561169733/355533001169730.
355170561169741/355533001169748. 355170561169758/355533001169755. 355170561169766/355533001169763. 355170561169808/35553300116980
5. 355170561169824/355533001169821. 355170561169907/355533001169904. 355170561170087/355533001170084. 355170561170210/35553300117
0217. 355170561170228/355533001170225. 355170561170236/355533001170233. 355170561170244/355533001170241. 355170561170566/35553300
1170563. 355170561170681/355533001170688. 355170561170897/355533001170894. 355170561170954/355533001170951. 355170561171036/35553
3001171033. 355170561171051/355533001171058. 355170561171101/355533001171108. 355170561171135/355533001171132. 355170561120876/35
5533001120873. 355170561121098/355533001121095. 355170561122187/355533001122184. 355170561122195/355533001122192. 355170561122237
/355533001122234. 355170561122286/355533001122283. 355170561122815/355533001122812. 355170561122823/355533001122820. 355170561122
914/355533001122911. 355170561122955/355533001122952. 355170561122971/355533001122978. 355170561123003/355533001123000. 355170561
123086/355533001123083. 355170561125081/355533001125088. 355170561125099/355533001125096. 355170561126626/355533001126623. 355170
561127434/355533001127431. 355170561127806/355533001127803. 355170561128556/355533001128553. 355170561128762/355533001128769. 355
170561129299/355533001129296. 355170561129323/355533001129320. 355170561129356/355533001129353. 355170561129372/355533001129379.
355170561129414/355533001129411. 355170561129430/355533001129437. 355170561132889/355533001132886. 355170561133986/35553300113398
3. 355170561134612/355533001134619. 355170561134687/355533001134684. 355170561135627/355533001135624. 355170561135635/35553300113
5632.355170561135643/355533001135640. 355170561135650/355533001135657. 355170561135668/355533001135665. 355170561135676/355533001
135673. 355170561135684/355533001135681. 355170561135692/355533001135699. 355170561135718/355533001135715. 355170561135908/355533
001135905. 355170561147473/355533001147470. 355170561147598/355533001147595. 355170561147630/355533001147637. 355170561147887/355
533001147884. 355170561147945/355533001147942. 355170561161839/355533001161836. 355170561161870/355533001161877. 355170561161946/
355533001161943. 355170561161979/355533001161976.355170561163488/355533001163485. 355170561163587/355533001163584. 35517056116388
4/355533001163881. 355170561163942/355533001163949. 355170561164023/355533001164020. 355170561164080/355533001164087. 35517056116
4494/355533001164491. 355170561164544/355533001164541. 355170561164593/355533001164590. 355170561165228/355533001165225. 35517056
1165657/355533001165654. 355170561165665/355533001165662. 355170561165673/355533001165670. 355170561165723/355533001165720. 35517
0561165772/355533001165779. 355170561165780/355533001165787. 355170561165806/355533001165803. 355170561165822/355533001165829. 35
5170561165848/355533001165845. 355170561165855/355533001165852. 355170561165897/355533001165894. 355170561165921/355533001165928.
355170561165954/355533001165951. 355170561165970/355533001165977. 355170561165988/355533001165985. 355170561165996/3555330011659
93. 355170561166002/355533001166009. 355170561166010/355533001166017. 355170561166028/355533001166025. 355170561166044/3555330011
66041. 355170561166085/355533001166082. 355170561166119/355533001166116. 355170561166127/355533001166124. 355170561166150/3555330
01166157. 355170561166259/355533001166256. 355170561166267/355533001166264. 355170561166366/355533001166363. 355170561166382/3555
33001166389. 355170561166390/355533001166397. 355170561166473/355533001166470. 355170561147986/355533001147983. 355170561148034/3
55533001148031. 355170561148240/355533001148247. 355170561148398/355533001148395. 355170561148414/355533001148411. 35517056114842
2/355533001148429. 355170561148448/355533001148445. 355170561148455/355533001148452. 355170561148489/355533001148486. 35517056114
8497/355533001148494. 355170561148513/355533001148510. 355170561148547/355533001148544. 355170561148562/355533001148569.355170561
148570/355533001148577. 355170561148604/355533001148601. 355170561148786/355533001148783. 355170561148844/355533001148841. 355170
561148851/355533001148858. 355170561148877/355533001148874. 355170561148935/355533001148932. 355170561148943/355533001148940. 355
170561148950/355533001148957. 355170561148968/355533001148965. 355170561148976/355533001148973. 355170561148984/355533001148981.
355170561149016/355533001149013. 355170561149024/355533001149021. 355170561149032/355533001149039. 355170561149065/35553300114906
2. 355170561149107/355533001149104.355170561149123/355533001149120. 355170561149131/355533001149138. 355170561149172/355533001149
179. 355170561149255/355533001149252. 355170561149289/355533001149286. 355170561149321/355533001149328. 355170561149560/355533001
149567. 355170561149800/355533001149807. 355170561149834/355533001149831. 355170561149966/355533001149963. 355170561150105/355533
001150102. 355170561150204/355533001150201. 355170561150212/355533001150219. 355170561150246/355533001150243. 355170561171143/355
533001171140. 355170561171192/355533001171199. 355170561171242/355533001171249. 355170561171267/355533001171264. 355170561171275/
355533001171272. 355170561171283/355533001171280. 355170561171366/355533001171363. 355170561171374/355533001171371. 3551705611715
07/355533001171504. 355170561171549/355533001171546. 355170561171564/355533001171561. 355170561172893/355533001172890. 3551705611
72919/355533001172916. 355170561172927/355533001172924. 355170561172935/355533001172932. 355170561172943/355533001172940. 3551705
61172950/355533001172957. 355170561172968/355533001172965. 355170561172976/355533001172973. 355170561173024/355533001173021. 3551
70561173065/355533001173062. 355170561173339/355533001173336. 355170561173594/355533001173591. 355170561173610/355533001173617. 3
55170561173636/355533001173633. 355170561173644/355533001173641. 355170561173669/355533001173666. 355170561173735/355533001173732
. 355170561174584/355533001174581. 355170561174626/355533001174623. 355170561174634/355533001174631. 355170561174642/355533001174
649. 355170561174683/355533001174680. 355170561174691/355533001174698. 355170561174725/355533001174722. 355170561174741/355533001
174748. 355170561174766/355533001174763. 355170561174808/355533001174805. 355170561174816/355533001174813.355170561174824/3555330
01174821. 355170561174832/355533001174839. 355170561174857/355533001174854. 355170561174865/355533001174862. 355170561174873/3555
33001174870. 355170561174915/355533001174912. 355170561174931/355533001174938. 355170561174949/355533001174946. 355170561174980/3
55533001174987. 355170561174998/355533001174995. 355170561175003/355533001175000. 355170561175011/355533001175018. 35517056117502
9/355533001175026. 355170561175045/355533001175042. 355170561175052/355533001175059. 355170561175060/355533001175067XXXXXXXXXXXXX
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032024001286124-4
Espacio para uso exclusivo de la Entidad Recaudadora
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